Provider Demographics
NPI:1568440840
Name:FLAX-HEYER, SUSAN MICHELLE (CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MICHELLE
Last Name:FLAX-HEYER
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21217 NASHVILLE ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1451
Mailing Address - Country:US
Mailing Address - Phone:818-359-7075
Mailing Address - Fax:866-270-8005
Practice Address - Street 1:21217 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1451
Practice Address - Country:US
Practice Address - Phone:818-349-3280
Practice Address - Fax:818-349-3290
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA348033163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant